穿孔性阑尾炎与非穿孔性阑尾炎的CT鉴别诊断价值

Diagnostic Value of CT in Perforated Appendicitis and Non-perforated Appendicitis

目的分析CT鉴别诊断穿孔性阑尾炎和非穿孔性阑尾炎的临床价值。方法选取我院2017年1月-2018年7月期间收治的60例急性阑尾炎患者(穿孔性阑尾炎26例,非穿孔性阑尾炎34例),所有患者均采用CT检查,对比分析两组患者CT检查结果。结果穿孔性阑尾炎组患者阑尾直径(13.8±3.3)mm明显大于非穿孔性阑尾炎组患者(9.9±3.2)mm(t=4.402, P<0.05)。两组患者阑尾部位差异无统计学意义(P>0.05)。穿孔组对阑尾腔内粪石(65.4%)、阑尾腔外粪石(11.5%)、阑尾腔外气体(26.9%)、阑尾壁局限性强化缺损(57.7%)、阑尾周围脓肿(19.2%)、盆腔炎改变(65.4%)、阑尾周围炎(轻中度)(100.0%)、阑尾周围炎(中重度)(62.9%)等CT征象检出率明显高于非穿孔组的41.2%、0.0%、0.0%、0.0%、0.0%、11.8%、50.0%、17.6%。结论 CT检查在临床鉴别诊断穿孔性阑尾炎、非穿孔性阑尾炎方面具有较高价值,特别是诊断穿孔性阑尾炎具有较高特异性,可在临床上广泛推广应用。

Objective To analyze the clinical value of CT in the diagnosis of perforated appendicitis and non-perforated appendicitis.Methods Sixty patients with acute appendicitis(26 perforated appendicitis and 34 nonperforated appendicitis)were enrolled in our hospital from January 2017 to July 2018.All patients underwent CT examination.test result.Results The diameter of the appendix(13.8±3.3)mm was significantly greater in the perforated appendicitis group than in the non-perforated appendicitis group(9.9±3.2)mm(t=4.402,P<0.05).There was no statistically significant difference in the appendix between the two groups(P>0.05).Perforation group in the appendix cavity(65.4%),appendix cavity(11.5%),appendicular gas(26.9%),appendix wall localized enhancement defect(57.7%),appendix abscess(19.2%).The detection rate of CT signs such as pelvic inflammatory disease(65.4%),inflammation around the appendix(light moderate)(100.0%),inflammation around the appendix(medium-to-severe)(62.9%)was significantly higher than that of the non-perforated group 41.2%,0.0%,0.0%,0.0%,0.0%,11.8%,50.0%,17.6%.Conclusion The CT examination has high value in clinical differential diagnosis of perforated appendicitis and non-perforated appendicitis.Especially,the diagnosis of perforated appendicitis has high specificity and could be widely applied in clinic.